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* 1. Please complete the contact information below:

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* 2. School Name:

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* 3. FCCLA Adviser's Name:

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* 4. What grade will you be in starting in August?

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* 5. Parent/Emergency Contact's Name:

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* 6. Parent/Emergency Contact's Cell Phone Number:

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* 7. Registration choice (cost per person - all meals and sleeping room included:

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* 8. I would like for my roommate(s) to be:

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* 9. T-shirt size:

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* 10. List any food allergies or special food requirements that you have:
If none, put NA in the box.

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* 11. I understand that I am not to drive myself to FCCLA Leadership Camp. 
I will be brought to the Leadership Camp by:

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* 12. If last choice was chosen in question 11,
   Other School Adviser's Name:

You and your FCCLA Adviser should receive an email with an invoice for your registration fees, and camp waiver forms for you to sign and bring with you to the Leadership Camp after the May 15th deadline. 

Please note that your registration will be final after the May 15th deadline and NO REFUNDS will be allowed.  Payment will be required whether you attend or not. 

Payments in the form of a check or money order, may be mailed in advance to Illinois Association of FCCLA,
8 South Washington Street, Suite 105, Sullivan, IL  61951 or presented at the Leadership Camp Registration Desk on July 7th.

Questions or concerns that you might have should be emailed to:  ilfccla@gmail.com  with "Summer Leadership Camp" in the subject line.

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